Medications for Gout
Main Page | Risk Factors | Symptoms | Diagnosis | Treatment | Screening | Reducing Your Risk | Talking to Your Doctor | Living With Gout | Resource Guide
The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Medications are the primary treatment for gout. There are a number of medications used to treat gout.
Prescription Medications
- Colchicine
- Corticosteroids
- Prednisone
- Prednisolone
- Apo-Prednisone
- Allopurinol
- Zyloprim
- Probenecid
- Benemid
Prescription or Over-the-Counter Medications
- Nonsteroidal Anti-inflammatory Drugs
- Ibuprofen (Apo-Ibuprofen)—OTC or prescription
- Indomethacin (Indocin)—prescription only
- Naproxen (Aleve)—OTC or prescription
- Diclofenac (Cataflam)—prescription only
Prescription Medications
Colchicine
Colchicine is given during a gout attack to relieve the pain, swelling, and inflammation. It works by decreasing the acidity of joint tissue and preventing deposits of uric acid crystals in joints. This medication may also be taken in smaller doses to help prevent recurrent gout attacks. Colchicine is given either by mouth or by IV in a vein. When taken orally, it should be taken with food or liquids to help prevent stomach upset.
Possible side effects include:
- Diarrhea
- Nausea
- Vomiting
- Abdominal pain
- Kidney failure
- Muscle pain
- Peripheral nerve dysfunction
Consult your doctor before taking colchicine if you:
- Have a gastrointestinal disorder
- Have a history of peptic ulcers or ulcerative colitis
- Drink large amounts of alcohol
- Have heart, liver, or kidney disease
- Will have surgery within two months
- Have a blood disorder
Corticosteroids
Common names include:
- Prednisone
- Prednisolone
- Betametasone (for joint injection)
- Triamcinalone (for joint injection)
- Methylprednisolone (given IV, usually for severe cases)
Corticosteroids can control the pain, swelling, and inflammation of joints caused by gout. The medication can be given as a tablet or in liquid form or by injection into a joint—or in severe cases, by vein. If taken orally, corticosteroids are best taken at the same time(s) each day and should be taken with liquid or food to lessen stomach upset.
Possible side effects include:
- Acne
- Poor wound healing
- Indigestion, nausea, or vomiting
- Diarrhea
- Headache
- Appetite gain or loss
- Psychiatric disturbances
- Weight gain
-
Severe side effects may include:
- Hives
- Rash
- Faintness
-
Long term use may cause:
- Slowed growth in children
- Glaucoma
- Cataracts
- Diabetes
- Thinning of the skin
- Weak, fragile bones
- High blood pressure
Allopurinol
Common names include:
Allopurinol is sometimes given to people who suffer repeated gout attacks, especially when tophi deposits, collections of uric acid crystals, develop. This medication slows the development of uric acid by inhibiting the activity of certain enzymes. It is given in tablet form and should be taken at the same time (or times) each day with food or liquid to help avoid stomach upset.
Possible side effects include:
- Rash, which may progress to a life-threatening condiition
- Diarrhea
- Nausea
- Vasculitis, inflammation of blood vessels
- Bone marrow suppression
- Liver or kidney problems
Consult with your doctor before taking allopurinol if you:
- Have an acute attack of gout
- Have kidney or liver problems
- Have Cancer
- Use diuretics
- Have an allergy to penicillin drugs
- Have recently used immunosuppressive drugs
Probenecid
Common names include:
- Benemid
Probenecid is sometimes given to patients who suffer repeated gout attacks (especially when tophi deposits develop). This medication forces the kidneys to excrete additional uric acid. It is given in tablet form and should be taken at the same time each day with food or liquid to help avoid stomach upset.
Possible side effects include:
- Headache
- Appetite loss
- Nausea
- Vomiting
- Kidney disease (with prolonged use)
- Kidney stones
Consult your doctor before taking probenecid if you have:
- An acute attack of gout
- Kidney stones or kidney disease
- Peptic ulcer
- A blood disorder
- Cancer
Prescription and Over-the-Counter Medications
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Common names include:
- Ibuprofen (Apo-Ibuprofen)
- Indomethacin (Indocin)
- Naproxen (Aleve)
- Diclofenac (Cataflam)
NSAIDs are given to treat the pain, inflammation, and swelling caused by gout attacks. They can be purchased over-the-counter or your doctor may prescribe a higher dosage. They work by decreasing prostaglandins, hormones that produce inflammation and pain. The medication may also be taken in smaller doses to help prevent attacks in patients with recurrent gout attacks. NSAIDs are given in tablet, capsule, or liquid form. They should be taken at the same time (or times) each day and should be taken with food or liquid to help avoid stomach upset.
Possible side effects include:
- Indigestion, ulcers, gastrointestinal bleeding, abdominal pain
- Hives
- Rash
- Intense itching
- Faintness
- Nausea
- Asthma
- Heart disease
Consult your healthcare provider before taking NSAIDs if you have:
- Mental or neurological illness
- Impaired liver or kidney function
- High blood pressure or heart disease
- History of stomach ulcers or reflux disease
- Cardiovascular disease
- Risk factors for cardiovascular disease like high blood pressure, diabetes, high cholesterol , smoking, or a family history of early heart attacks
A recent study suggests that corticosteroids and NSAIDS are equally effective for acute gout, but corticosteroids are comparatively safer, at least in the short-term. Researchers randomly divided 90 patients older than 17 presenting to an emergency room with symptoms of gout into two groups. One group was given a NSAID (indomethacin) plus acetominophen (eg, Tylenol) and the other was given a corticosteroid (prednisolone) plus acetopminophen. Both groups had a similar reduction in their pain, but the corticosteroid group had fewer adverse effects. *
Special Considerations
Whenever you are taking a prescription medication, take the following precautions:
- Take your medication as directed. Do not change the amount or the schedule.
- Do not stop taking them without talking to your doctor.
- Do not share them.
- Know what the results and side effects. Report them to your doctor.
- Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
- Plan ahead for refills so you don’t run out.
When to Contact Your Doctor
Contact your doctor if:
- You develop side effects from any medication you take
- Your symptoms worsen, do not improve, or keep coming back
References:
American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html .
American College of Rheumatology website. Available at: http://www.rheumatology.org/ .
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .
The Merck Manual of Medical Information. 17th ed. Simon and Schuster, Inc; 2000.
Updated Nonsteroidal Anti-inflammatory Drugs (NSAIDs) section on 7/19/2007 according to the following study, as cited by DynaMed's Systematic Literature Surveillance : Man CY, Cheung IT, Cameron PA, Rainer TH. Comparison of oral prednisolone/paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute goutlike arthritis: a double-blind, randomized, controlled trial. Ann Emerg Med. 2007;49:670-677. Epub 2007 Feb 5.
Last reviewed February 2009 by Jill D. Landis, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.